Balloon vaginoplasty as a minimally invasive method in the management of vaginal aplasia

Czech version

Authors: K. Maršálková ¹; Radovan Pilka ²
Authors‘ workplace: Porodnicko-gynekologické oddělení, Nemocnice Šumperk a. s. ¹; Porodnicko-gynekologická klinika LF UP a FN Olomouc ²
Published in: Ceska Gynekol 2022; 87(3): 206-210
Category: Review Article
doi: https://doi.org/10.48095/cccg2022206

Overview

Objective: The aim of this article is to describe the management of vaginal aplasia and to introduce minimally invasive surgical procedures for neovagina formation. Methodology: Literature review obtained from studies and papers dealing with the management of congenital vaginal aplasia. Conclusion: Vaginal aplasia is a rare congenital anomaly, often in coincidence with congenital defects of the uropoietic system. Management nowadays favors non-surgical or minimally invasive surgical methods for neovagina formation. Saman et al introduced a new method of neovagina formation, namely balloon vaginoplasty. The advantage of the surgical procedure is traction using a soft Foley balloon, determining both the length and width of the neovagina. The method uses the expansion of the natural vaginal mucosa without the need for dissection of the vesicorectal space. The soft Foley balloon does not cause erosion of the vaginal mucosa.

Keywords:

Mayer-Rokitansky-Küster-Hauser syndrome – vaginal aplasia – minimally invasive surgical method of neovagina formation – laparoscopically assisted balloon vaginoplasty – retropubic balloon vaginoplasty

Sources

1. Herlin MK, Petersen MB, Brännstöm M et al. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: a comprehensive update. Orphanet J Rare Dise 2020; 15(1): 214. doi: 10.1186/ s13023- 020-01491-9.

2. Hořejší et al (eds). Dětská gynekologie. 2. vyd. Praha: Mladá Fronta 2019.

3. R. Chmel Jr., M. Nováčková, N. Sexualita žen s syndromem Mayer-Rokitansky-Küster-Hauser. Ceska Gynekol 2021; 86(3): 194–199. doi: 10.48095/ cccg2021194.

4. Benedetti Panici P, Maffucci D, Ceccarelli S et al. Autologous in vitro cultured vaginal tissue for vaginoplasty in women with Mayer-Rokitansky- Küster-Hauser syndrome: anatomic and functional results. J Minim Invasive Gynecol 2015; 22(2): 205–211. doi: 10.1016/ j.jmig.2014.09.012.

5. Chmel R Jr, Pastor Z, Mužík M et al. Syndrom Mayer-Rokitansky-Küster-Hauser – ageneze dělohy a pochvy: aktuální znalosti a terapeutické možnosti. Ceska Gynek 2019; 84(5): 386–392.

6. Rejdová I, Petrenko M, Hodická Z. Laparoskopicky asistovaná neoplastika pochvy podle Vecchiettiho. Ceska Gynekol 2012; 77(2): 104–108.

7. Frank TR. The formation of an artificial vagina without operation. Am J Obstet Gynecol 1938; 35: 1053–1055.

8. El Saman AM, Fathalla MM, Nasr AM et al. Laparoscopically assisted balloon vaginoplasty for management of vaginal aplasia. Int J Gynecol Obstet 2007; 98(2): 134–137. doi: 10.1016/ j.ijgo.2007.04.013.

9. El Saman AM, Zakherah MS, Nasr AM et al. Distension versus traction in laparoscopically assisted balloon vaginoplasty for management of vaginal aplasia. Int J Gynaecol Obstet 2009; 104(1): 72–73. doi: 10.1016/ j.ijgo.2008.08.001.

10. Darwish AF, Mohammad AM. A new era for treating vaginal aplasia using transretropubic balloon vaginoplasty approach. Fertil Steril 2011; 95(3): 1104–1108. doi: 10.1016/ j.fertnstert.2010.12.013.

11. El Saman AM, Tawfik RM, Hussian M et al. Outpatient balloon vaginoplasty for treatment of vaginal aplasia: retropubic balloon vaginoplasty was performed as an office procedure under local anesthesia. Am J Obstet Gynecol 2011; 205(2): 161.e1–161.e3. doi: 10.1016/ j.ajog.2011.05.025.

12. El Saman AM, Ismael AM, Zakherah MS et al. Enhancement balloon vaginoplasty for treatment of blind vagina due to androgen insensitivity syndrome. Fertil Steril 2011; 95(2): 779–782. doi: 10.1016/ j.fertnstert.2010.10.008.

13. El Saman AM, Fathalla MM, Zakherah MS et al. Modified balloon vaginoplasty: the fastest way to create a natural neovagina: minor changes in technique eliminate the need for customized instruments. Am J Obstet Gynecol 2009; 201(5): 546.e1–546.e5. doi: 10.1016/ j.ajog.2009.09.018.

14. El Saman AM, Abdel-Aleem M, Habibe DM et al. Failed vaginoplasty: a successful novel blend of minimally invasive approaches. Eur J Obstet Gynecol Reprod Biol 2012; 160(1): 84– 87. doi: 10.1016/ j.ejogrb.2011.09.044.

15. El Saman AM, Saadeldeen H, Tawfi k RM et al. A rescue management plan for ruptured balloons during balloon vaginoplasty. Eur J Obstet Gynecol Reprod Biol 2012; 165(1): 82–85. doi: 10.1016/ j.ejogrb.2012.06.025.

16. Letters to the editor – brief communications. Eur J Obstet Gynecol Reprod Biol 2016; 201: 219–230.